Provider Demographics
NPI:1669085270
Name:ACCINELLI, TENEISHA C (RN)
Entity type:Individual
Prefix:
First Name:TENEISHA
Middle Name:C
Last Name:ACCINELLI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1121
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-0254
Mailing Address - Country:US
Mailing Address - Phone:541-672-2691
Mailing Address - Fax:541-673-5642
Practice Address - Street 1:400 VIRGINIA AVE STE 100
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-3477
Practice Address - Country:US
Practice Address - Phone:541-490-2022
Practice Address - Fax:844-847-8136
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201805758RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse